Walking into the dental clinic at the United States Disciplinary Barracks at Fort Leavenworth, Kansas, is like entering any military dental clinic. The environment is welcoming with a staff ready and willing to assist you with any dental needs including treatment for a dental emergency, a periodic exam, extractions, cleaning, or an operative procedure. The dental staff is trained and capable of handling all tasks. The differences are that the clinic is located in a maximum-security military prison, the patients are prison inmates, and six of the dental assistants are prison inmates.

Being the only maximum-security prison in the Department of Defense, the United States Disciplinary Barracks (USDB) at Fort Leavenworth, prides itself on maintaining order in a world that can sometimes be chaotic. Within the guarded multiple 14-foot fences reside male criminals who have been convicted of crimes including murder, rape, and aggravated assault while serving in the U.S. Armed Forces. Many qualified inmates at USDB take advantage of the many treatment and vocational programs available. The rationale is that if an inmate once had the desire to defend our country, perhaps he will also have the will to reform, rehabilitate, and receive a vocational education.

The dental assistant training gives the inmates the opportunity to remain busy and productive while in prison and potentially to receive time off their sentence.

To be accepted into this program, the inmate must first express an interest in being a part of the apprenticeship program and submit the appropriate paperwork. This request then goes through an approval process from the inmate's current detail supervisor, to an academics committee, to the DTP (director of treatment programs), and then to the Non-Commissioned Officer in Charge (NCOIC) of the dental clinic. The NCOIC has a function similar to a practice manager. Although there are many factors that are considered in selecting the six inmates who will work in the dental clinic, their present mental state as well as their behavior and disciplinary tracks are of the utmost importance.

Once accepted into the program the inmates receive clinical training that will allow them to flourish in the dental assisting profession. The inmates in the dental clinic are taught to interact in a professional manner that is conducive to a business setting. Most importantly, the dental assistants working within the confines of USDB gain one thing that most criminals lack, a sense of self-worth. Research has often

shown that someone who is well grounded and has a definite idea of self is less likely to commit a crime.

The training includes:

* 200 hours Record keeping and charting

* 400 hours Diagnosis and armamentarium

* 300 hours Sterilization procedures

* 100 hours X-ray technique and safety

* 200 hours Dental specialties and instruments

* 300 hours Care of dental equipment and supplies

* 300 hours Mixing of dental materials

* 200 hours Dental hygiene and oral health

The dental assistants I encountered during my visit to the clinic were clearly working as a team in an attempt to accomplish one goal. That is, to ensure that all patients, regardless of the fact that they are inmates, receive the best dental care possible. That is not to say that the inmates working in the dental clinic are not reminded every day that they are, indeed, in prison.

Because the USDB is the only dental clinic in the Department of Defense that uses inmates as part of the staff, special precautions do need to be taken. It is a fact that ultimately, the clinic is still a part of the prison and therefore, guidelines must be implemented to ensure the safety of the dental staff including the inmates. Upon entering the medical and dental clinics, all personnel must go through a metal detector. Video camera surveillance is also evident and present to capture irregularities in inmate behavior. In the dental clinic, all materials and instruments are counted and weighed prior to the beginning of the day and before inmates leave the premises. This is done to ensure that no sharp instruments or other medical supplies leave the dental clinic.

My visit to the dental clinic within the USDB was indeed, an eye-opening experience. I was impressed with the dental clinic staff, first, because they run an efficient and welcoming dental clinic. But also, because in essence, all of the staff also serve as prison guards ensuring that the inmates act appropriately at all times. The dental staff goes about their day executing routine dental work while teaching and overseeing the rehabilitation of six inmates. In a unique situation, this dental clinic staff has shown itself to be superlative not only in dental care, but, also in assuring that the inmates who participate in the dental apprenticeship program do not return to a life of crime once they exit the U.S. Disciplinary Barracks.